Central nervous system symptoms in mpox patients without HIV co-infection: a meta-analysis
Bibliographic record
Abstract
Background Co-infection with HIV in patients infected with the mpox virus (MPXV) may pose a potential risk of influencing neurological manifestations. We aimed to synthesize the central nervous system (CNS) symptoms reported by mpox patients without HIV co-infection. Methods We conducted a search for studies on mpox published in PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang Data, and Weipu Data till 2023/11/19. The type of studies included were cohort studies, case series, case–control trials, and randomized controlled trials. Reviews, editorials, pre-prints, and conference proceedings were excluded. We only included studies that reported neurological manifestations in mpox patients without HIV. STATA (version 16.0) was used to create forest plots that pooled the mean scores of CNS symptoms in mpox patients. Outcomes were presented with 95% confidence interval (95% CI), and heterogeneity was assessed using the I 2 statistic. Results We identified 2,311 unique studies, of which 14 (with a total of 989 patients) met the inclusion criteria. The quality of each study was assessed using the Newcastle-Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) tool. The majority of the included articles were rated as medium quality. The major CNS clinical features were myalgia, headache, and fatigue/asthenia, with pooled mean scores of 0.22 (95% CI: 0.13–0.31), 0.25 (95% CI: 0.17–0.33) and 0.28 (95% CI: 0.21–0.37) in mpox patients without HIV. The results of the sensitivity analysis showed that the meta-analysis results were stable. Additionally, Egger’s test ( p < 0·05) suggested that a low risk of publication bias in the included literature. Conclusion The MPXV may cause clinical nervous system injuries, including headache, myalgia, and fatigue/asthenia, as observed in approximately 25% (±3%) of the studied population. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024464199 , CRD42024464199.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.018 | 0.054 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".